Lisa Hathaway '89 Looks at Healthcare With a Legal Eye
Hathaway earned her bachelor’s degree in nursing in 1982 and was working on a master’s degree in nursing; she considered medical school. In the course of her studies, she reviewed a few legal cases that piqued her interest in the law. So she decided a change of career might be in order.
“I took the LSATs and did pretty well!” she says. So she entered the University of Cincinnati College of Law. Luckily, she still had her nursing degree to fall back on, she says: “I worked as a nurse during law school so I could eat.”
She passed the bar in 1989. Her first position was as a risk manager for Riverside Methodist Hospitals (now OhioHealth). Then she went to work for Baker & Hostetler, also in Columbus, as a staff attorney.
“I was lucky enough to land an in-house corporate position with HCR Manor Care just five and a half years out of law school,” she says. She worked a total of 10½ years there, half of which was in the legal department as one of the attorneys, the other half as the national director of managed care contracting — in addition to being one of the attorneys in the legal department.
At that point Hathaway was recruited by Blue Cross/Blue Shield of Florida. “I was glad to leave my snow shovel behind!” she says. Now, as one of 12 assistant general counsel attorneys (in addition to one deputy general counsel and two vice president senior counsels), she works on complex contracts, Medicare Advantage and Part B issues. She frequently works with payment issues and care management staff. “I also support the special investigative unit on fraud and abuse,” she adds.
Hathaway is active in the American Health Lawyers Association, a legal organization of 11,200 attorneys. She was elected to the board in 2011. Prior to that she chaired the Payors, Plans and Managed Care Practice Group for three years. Hathaway is also a board member of the North Florida Chapter of the National Multiple Sclerosis Society. She is a frequent speaker at educational meetings, especially on topics related to long-term care, Medicare abuse and managed care contracting.
Hathaway says that she owes her knowledge of advanced contracting to College of Law Professor Alfonse Squillante. “He was the hardest contracting professor at UC,” she says. “I like contracting law now, but back then I had no idea what I was reading. It was so hard.” She recalls how he had students on the very first day stand in front of the class (Cris Collinsworth was a classmate, in fact) while he grilled them with questions as “Judge Squillante.” Although Prof. Squillante died in 1999, Hathaway had been able to convey the effect he had on her career. “He made me love contracts to this day.” Read more about Professor Alphonse Squillante in UC Magazine.
Lisa Hathaway shared her reaction to the recently announced United Supreme Court Decision in regards to the Patient Protection and Affordable Care Act:
The United States Supreme Court (“Court”) decision has limited precedential value as it was a 5-4 decision in regards to the individual mandate and the constitutionality of the 2010 Patient Protection and Affordable Care Act (“PPACA”). Only five of the Justices, including Chief Justice Roberts, agreed on the remedy of treating the mandate, which requires most Americans maintain “minimum essential” health insurance coverage as a tax and not a penalty (even though in PPACA, the word “penalty” is mentioned 18 times and it is never mentioned that it is a tax). The dissent by four of the Justices (Scalia, Kennedy, Thomas and Alito), which is very good, clearly sets forth these four Justices’ conclusions in regards to PPACA, the constitution, the separation of powers and their analysis of Congress’s intent. The dissent focuses on two questions of first impression regarding whether the “failure to engage in economic activity (the purchasing of health insurance) is subject to regulation under the commerce clause” and whether “Congress’s power to tax and spend permits the conditioning of a State’s continued receipt of all funds under the massive state administered welfare program upon its acceptance of an expansion to that program.” The dissent addresses whether failure to act may affect commerce (or not), and how the Court has never found a law enacted under the spending power to be “coercive.” The decision is a good read. Finally, what is more compelling is the 7-2 decision in regards to PPACA’s expansion of the Medicaid program. The Court concluded that Congress cannot compel the States to expand Medicaid to adults up to 133% of the federal poverty level and use the threat of the withdraw of all federal funding for a State for Medicaid if a State does not comply (increasing the coverage requirements and types of individuals covered). It is viewed by many that the Medicaid expansion in the PPACA is in essence an element of a comprehensive plan for universal health care coverage. And now, even with this Supreme Court opinion on PPACA’s constitutionality, the debate continues and there will continue to be much political and legislative activity in regards to health care and reform.